title: Laparoscopic management of ureteral lesions in gynecology.
abstract: OBJECTIVE
  To investigate the outcome of laparoscopic repair of ureteral injury in laparoscopic gynecologic surgery.
  
  
  METHODS
  Prospective trial.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Forty patients with a ureteral lesion in laparoscopic surgery between 1991 and 2007.
  
  
  METHODS
  Laparoscopic ureteral repair, laparoscopic-assisted or blind stent insertion.
  
  
  METHODS
  Treatment outcome of ureteral lesion analyzed by type of injury, time of diagnosis, and management.
  
  
  RESULTS
  In 4,350 consecutive laparoscopic gynecologic interventions, 42 lesions occurred, 5 during hysterectomy, 1 during adnexectomy, and 36 during deep endometriosis surgery. In the latter group (n = 1,427), the incidence was 1.5% and 21% in women without and with hydronephrosis, respectively. In eight women in whom a stent was inserted after surgery without laparoscopic guidance, five were uneventful and three needed a second intervention. In all 34 women in whom a laparoscopic repair over a stent was performed, the outcome was uneventful, whether diagnosed and treated during surgery (n = 25) or after surgery (n = 9).
  
  
  CONCLUSIONS
  Laparoscopic repair over a stent was uneventful for all lacerations, transections, and fistulas, whether performed during or after surgery, and was superior to blind stent insertion. In women with hydronephrosis and deep endometriosis, a preoperative stent insertion seems to be mandatory.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Department of Obstetrics and Gynecology, University Hospital A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: carlodecicco@gmail.com.
authors.forename: Carlo
authors.initials: C
authors.lastname: De Cicco
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Ron
authors.initials: R
authors.lastname: Schonman
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Marleen
authors.initials: M
authors.lastname: Craessaerts
authors.affiliation: Department of Urology, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Ben
authors.initials: B
authors.lastname: Van Cleynenbreugel
authors.affiliation: Department of Obstetrics and Gynecology, Villa Giose, Crotone, Italy.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Ussia
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Department of Obstetrics and Gynecology, University Hospital A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Philippe Robert
authors.initials: PR
authors.lastname: Koninckx
mesh_terms: D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D012189:Retrospective Studies; D015607:Stents; D025321:Surgery, Computer-Assisted / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome; D014513:Ureter / Q000293:injuries / Q000601:surgery; D014515:Ureteral Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery*; D014546:Urinary Catheterization / Q000379:methods / Q000706:statistics & numerical data